Members rights and responsibilities
Aetna Better Health members, their families and guardians have the right to information related to their treatment or treatment options in a manner, and language appropriate to the member’s condition and ability to understand.
As a HealthChoice member, you have the right to:
- Receive health care and services that are culturally competent and free from discrimination.
- Be treated with respect to your dignity and privacy.
- Receive information, including information on treatment options and alternatives, regardless of cost or benefit coverage, in a manner you can understand.
- Participate in decisions regarding your healthcare, including the right to refuse treatment.
- Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation.
- Request and receive a copy of your medical records and request that they be amended or corrected as allowed.
- Request copies of all documents, records, and other information free of charge, that was used in an adverse benefit determination.
- Exercise your rights, and that the exercise of those rights does not adversely affect the way Aetna Better Health of Maryland, their providers, or the Department of Health and Mental Hygiene treat you.
- File appeals and grievances with Aetna Better Health of Maryland.
- File appeals, grievances and State fair hearings with the State.
- Request that ongoing benefits be continued during an appeal or state fair hearing however, you may have to pay for the continued benefits if the decision is upheld in the appeal or hearing.
- Receive a second opinion from another doctor within Aetna Better Health of Maryland, or by an out of network provider if the provider is not available within the Aetna Better Health of Maryland network, if you do not agree with your doctor’s opinion about the services that you need. Contact your Aetna Better Health of Maryland for help with this.
- Receive other information about how Aetna Better Health of Maryland is managed including the structure and operation of Aetna Better Health of Maryland as well as physician incentive plans. You may request this information by calling Aetna Better Health of Maryland.
As a HealthChoice member, you have the responsibility to:
- Inform your provider and Aetna Better Health of Maryland if you have any other health insurance coverage.
- Treat HealthChoice staff, Aetna Better Health of Maryland staff, and health care providers and staff, with respect and dignity.
- Be on time for appointments and notify providers as soon as possible if you need to cancel an appointment.
- Show your membership card when you check in for every appointment. Never allow anyone else to use your Medicaid or Aetna Better Health of Maryland card. Report lost or stolen member ID cards to Aetna Better Health of Maryland.
- Call Aetna Better Health of Maryland if you have a problem or a complaint.
- Work with your Primary Care Provider (PCP) to create and follow a plan of care that you and your PCP agree on.
- Ask questions about your care and let your provider know if there is something you do not understand.
- Update the State if there has been a change in your status
- Provide Aetna Better Health of Maryland and their providers with accurate health information in order to provide proper care.
- Use the emergency department for emergencies only.
- Tell your PCP as soon as possible after you receive emergency care.